Improved Efficiency of LigaSure Vessel Sealing System for Recipient Hepatectomy in Liver Transplantation

Abstract

Vessel sealing devices expedite surgical procedures by the reliable sealing and dividing of vessels in one action that otherwise require multiple steps for ligation and division. Although the LigaSure device is widely used, its use in liver transplantation where compounding factors of portal hypertension, coagulopathy, and thrombocytopenia exist is poorly described. Methods: From October 1, 2011 to December 31, 2011, six patients underwent liver transplantation with recipient hepatectomy utilizing the LigaSure device for piggyback technique transplantation. Perioperative and intraoperative outcomes using the device were compared to six contemporaneous patients in whom the device was not used. Results: Patient demographics and pre-operative laboratory values and MELD scores were not significantly different. Recipient hepatectomy was performed, on average, 43 minutes faster using the LigaSure device (p = 0.02). Thermal spread was not observed to damage vascular structures. Although total operative time and intraoperative blood product usage were lower when the LigaSure was used, these differences did not reach statistical significance. Conclusions: LigaSure vessel sealing is an efficient method for recipient hepatectomy in liver transplantation. Vessel sealing of caval, portal, and other structures can be safely performed in the settings of end stage liver disease.